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      Adherence to and Dropout from Liraglutide 3.0 mg Obesity Treatment in a Real-World Setting

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          Abstract

          Background

          The factors associated with non-adherence to obesity treatment using liraglutide 3.0 mg in a real-world setting remain elusive.

          Methods

          We performed a secondary data analysis of 769 participants treated with liraglutide 3.0 mg from December 2017 to June 2020 at nine Korean hospitals. Data were collected 2, 4, and 6 months after treatment initiation. Adherence groups were defined as <2, 2–4, 4–6, and ≥6 months.

          Results

          Among the 769 patients, 539 (70.1%) were lost to follow-up within 6 months because of unknown reasons (54.2%), adverse events (14.8%), change of treatment (13.7%), or discontinuation due to poor weight loss (9.3%). Dropout at 6 months was significantly associated with the presence of diabetes mellitus in step 1 and the presence of diabetes mellitus with regular exercise in step 2 of the logistic regression analysis using the forward stepwise selection method. After adjusting for covariates, the presence of diabetes mellitus (odds ratio [OR], 0.25; 95% confidence interval [CI], 0.10–0.63; OR, 0.47; 95% CI, 0.31–0.73; and OR, 0.52; 95% CI, 0.34–0.80) and regular exercise (OR, 2.86; 95% CI, 1.31–6.23; OR, 2.09; 95% CI, 1.26–3.48; and OR, 2.99; 95% CI, 1.81–4.92) showed significant associations in the <2, 2–4, and 4–6 groups compared with the highest adherence group (≥6 months).

          Conclusion

          Non-adherence to obesity treatment with liraglutide is related to regular exercise and absence of diabetes mellitus. Further prospective studies are warranted to increase medication adherence in those groups.

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          Most cited references34

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          A new equation to estimate glomerular filtration rate.

          Equations to estimate glomerular filtration rate (GFR) are routinely used to assess kidney function. Current equations have limited precision and systematically underestimate measured GFR at higher values. To develop a new estimating equation for GFR: the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. Cross-sectional analysis with separate pooled data sets for equation development and validation and a representative sample of the U.S. population for prevalence estimates. Research studies and clinical populations ("studies") with measured GFR and NHANES (National Health and Nutrition Examination Survey), 1999 to 2006. 8254 participants in 10 studies (equation development data set) and 3896 participants in 16 studies (validation data set). Prevalence estimates were based on 16,032 participants in NHANES. GFR, measured as the clearance of exogenous filtration markers (iothalamate in the development data set; iothalamate and other markers in the validation data set), and linear regression to estimate the logarithm of measured GFR from standardized creatinine levels, sex, race, and age. In the validation data set, the CKD-EPI equation performed better than the Modification of Diet in Renal Disease Study equation, especially at higher GFR (P < 0.001 for all subsequent comparisons), with less bias (median difference between measured and estimated GFR, 2.5 vs. 5.5 mL/min per 1.73 m(2)), improved precision (interquartile range [IQR] of the differences, 16.6 vs. 18.3 mL/min per 1.73 m(2)), and greater accuracy (percentage of estimated GFR within 30% of measured GFR, 84.1% vs. 80.6%). In NHANES, the median estimated GFR was 94.5 mL/min per 1.73 m(2) (IQR, 79.7 to 108.1) vs. 85.0 (IQR, 72.9 to 98.5) mL/min per 1.73 m(2), and the prevalence of chronic kidney disease was 11.5% (95% CI, 10.6% to 12.4%) versus 13.1% (CI, 12.1% to 14.0%). The sample contained a limited number of elderly people and racial and ethnic minorities with measured GFR. The CKD-EPI creatinine equation is more accurate than the Modification of Diet in Renal Disease Study equation and could replace it for routine clinical use. National Institute of Diabetes and Digestive and Kidney Diseases.
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            Adherence to Medication

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              A Randomized, Controlled Trial of 3.0 mg of Liraglutide in Weight Management.

              Obesity is a chronic disease with serious health consequences, but weight loss is difficult to maintain through lifestyle intervention alone. Liraglutide, a glucagon-like peptide-1 analogue, has been shown to have potential benefit for weight management at a once-daily dose of 3.0 mg, injected subcutaneously.
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                Author and article information

                Journal
                J Obes Metab Syndr
                J Obes Metab Syndr
                Journal of Obesity & Metabolic Syndrome
                Korean Society for the Study of Obesity
                2508-6235
                2508-7576
                30 September 2022
                2 September 2022
                2 September 2022
                : 31
                : 3
                : 254-262
                Affiliations
                [1 ]Department of Family Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
                [2 ]Department of Family Medicine, Kyungpook National University Hospital, Daegu, Korea
                [3 ]Department of Family Medicine, Uijeongbu Eulji Medical Center, Eulji University School of Medicine, Uijeongbu, Korea
                [4 ]Department of Family Medicine, Korea University College of Medicine, Seoul, Korea
                [5 ]Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
                Author notes
                [* ] Corresponding author Soo Lim https://orcid.org/0000-0002-4137-1671 Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 82 Gumi-ro 173beon-gil, Bundang-gu, Seongnam 13620, Korea Tel: +82-31-787-7035 Fax: +82-31-787-4051 E-mail: limsoo@ 123456snu.ac.kr

                The first two authors contributed equally to this study.

                Author information
                https://orcid.org/0000-0002-4137-1671
                Article
                jomes-31-3-254
                10.7570/jomes22029
                9579476
                36050277
                68c4820d-e006-458e-be96-eed71c1a2c4e
                Copyright © 2022 Korean Society for the Study of Obesity

                This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 15 April 2022
                : 7 June 2022
                : 17 August 2022
                Categories
                Original Article

                diabetes mellitus,exercise,lost to follow-up,liraglutide,medication adherence

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